Neuropsycholog-left right disorientation

right left disorientation

1. Right-left disorientation Presented by Seethal p.m 2 nd msc psychology

2. Gerstmann syndrome Gerstmann syndrome is a rare neurological disorder consisting of a tetrad of symptoms which include impairment in performing calculations ( acalculia ), discriminating their own fingers (finger agnosia ), writing by hands ( agraphia ) and impairment of distinguishing left from right (left-right disorientation )

3. Right-left disorientation Right–left disorientation refers to the disturbances in the ability to identify right and left in one’s own body and in that of the examiner. It consequently includes not just linguistic but also spatial components . Right –left disorientation is also observed in cases of left posterior parietal damage and is included in the Gerstmann’s syndrome Left-right discrimination is a complex neuro -psychological process involving several higher neurological functions such as the ability to integrate sensory and visual information, language function and memory.

4. Right–left orientation refers to the ability to identify the right and left sides of one's own body, and to identify the right and left sides of a person seated opposite or in a photo or drawing. Individuals with right–left disorientation often demonstrate the sparing of other spatial concepts, such as up–down and front–back Right–left disorientation may develop consequent to broader disturbances of body schema or language processing, but it can exist as a fairly isolated symptom

5. Wolf (1973) examined the incidence of right–left confusion in a sample of physicians and their spouses. Results revealed that 17.5% of women and 8.8% of men sampled admitted to “frequent” right–left confusion . Harris and Gitterman (1978) assessed the frequency of right–left confusion in a sample of 364 university faculty members, and found greater error rates among females, especially left-handed females . Head (1926) and Bonhoeffer (1923) demonstrated that RLD was a consequence of left hemisphere lesions with associated aphasia, and specifically implicated the left retro Rolandic area.

6. McFie and Zangwill (1960) found RLD in 5 of 8 patients with left hemisphere lesions; in contrast, none of the 21 patients with right hemisphere lesions demonstrated the deficit. Ratcliff (1979) found that patients with right parietal-temporal-occipital lesions were impaired at making right– left judgments about inverted (upside down) figures, but not with upright figures. Ratcliff (1979) summarized his findings as lending support to the notion that the right posterior cortex was specialized for mental rotation.

7. Neuropsychological Evaluation of Right–Left Disorientation Formal examination of RLD makes demands on numerous cognitive abilities, including auditory comprehension, verbal expression of the labels “left” and “right,” short-term memory for the instructions, sensory discrimination, and mental rotation . identification of “right” and “left” may occur on one's own body, when confronting the examiner or picture, or during a combination of the two.

8. Diagnostic Assessment RLD may be driven by primary language factors such as comprehension deficits; anomia , which could cause confusion in the use of the “right” and “left” labels; and deficits in auditory retention TEST Right- left orientation test Standardized Road-Map Test of Direction Sense Laterality Discrimination Test

9. Right left orientation test 20-item test of simple and complex verbal commands to assess right–left orientation. The first 12 items involve discerning right from left on the subject's own body. The final eight questions necessitate right–left discrimination on the examiner or on a model that is at least 15 inches in height. Alternative forms of this test exist

10. Standardized Road-Map Test of Direction Sense This is a test of right–left orientation in extra personal space (Money, 1976). On an unmarked road map, the examiner draws a dotted pathway and the subject is asked to tell the direction (right or left) at each turn.

11. Laterality Discrimination Test The LDT (Culver, 1969) is a speeded task of laterality judgment and spatial perception. The stimuli consist of 32 line drawings of body parts (16 hands, 8 feet, 4 eyes, and 4 ears). Subjects are shown one card at a time, and are asked to judge whether the picture is a right or left body part

12. Thank you.